Being healthy without housing is hard. Being homeless can mean never getting a good night’s sleep, not having a place to refrigerate medication or being exposed to dangerous heat and freezing weather. With that understanding, the Oregon Health Authority is expanding the boundaries of traditional health care. As a result, more people in Salem will be able to pay their rent, get air conditioning and eat healthy food.The benefits are part of the state’s recent rollout of health-related social needs funds, which aim to improve the health of Oregon’s most vulnerable by addressing housing, nutrition, climate needs and improving access to services. It’s the first program of its kind in the country, according to the agency.It’s for a portion of people on the Oregon Health Plan who meet specific requirements like involvement in the child welfare system, recent incarceration or people who are homeless or at risk of becoming so.The benefits, which are complicated in eligibility and application, are accessible through community organizations, such as county, housing and nonprofit programs. PacificSource, the region’s Coordinated Care Organization, administers the grants to Salem-area organizations. Leslie Neugebauer, the health insurance provider’s vice president of community health, described the program as an innovation by the state to go beyond the national requirements of Medicaid.  States can “do an experiment of sorts” every five years, pitching new programs to the national Center for Medicare and Medicaid that they believe will make residents healthier, she said.The rollout began in March, with climate-focused support like mini-refrigerators for medication or air conditioners for people whose medical conditions worsen in heat. In January, qualifying people will be able to get delivered  meals recommended by a dietician to improve their health, and more support with navigating food programs.  Earlier this month, Marion and Polk County service providers got a $3.9 million boost to better help qualifying Oregon Health Plan members at risk of homelessness keep their housing through rental support, help with utility costs, eviction prevention and more.“They’re really focused on keeping people housed. There’s some reasonable evidence that when an individual is housed, versus when they become unhoused, there’s a correlation between how that affects their health,” Neugebauer said.  The housing-focused community capacity building grants that were awarded starting Nov. 1 went to 16 organizations in Marion and Polk Counties, with grants ranging between $9,772 and $780,395.  They include Marion County Health & Human Services, which received the largest grant, providers of homeless services like the Mid-Willamette Valley Community Action Agency and those organizations working at the intersection of health and housing, like HIV Alliance.Renee Yandel, executive director of HIV Alliance, works in supporting those with HIV or AIDS and to prevent new infections. She called the grants an innovative use of health care dollars. “Folks are more likely to engage in high-risk behaviors when they are experiencing housing instability, and less likely to access the medical care and behavioral health services that they need that help them stay HIV negative,” she said.  Her group will be using the $137,823 grant to improve its internal systems and train staff to provide housing support that clients would previously would have to go somewhere else to get.It’ll be one less hoop for clients to jump through, Yandel said.HIV Alliance typically spends a lot of time pursuing grants to help with housing and food insecurity, she said. The Medicaid funds improve treatment and prevention, she said. “Addressing the social determinants of health is a huge part of the work that we do,” she said. “We often are running into barriers for folks, not having adequate funding to help with the needs that they have.” Marion County Health & Human Services will use its $780,395 grant to expand housing support, said county Housing Program Supervisor Christina Bertschi.With the funds, the county’s housing navigators will provide more help for clients experiencing mental illness, substance use issues, people with intellectual and developmental disabilities and families in federal housing programs.They’ll do so by hiring two navigators, one who is bilingual, along with a new clinical supervisor and another office support specialist. It’ll allow them to be open for walk-ins at a kiosk in the county’s lobby.It’ll get more people off the rental assistance waitlists faster, Bertschi said. “Once somebody becomes homeless, it’s difficult to house them right away if they have an eviction on their record. Evictions really perpetuate the housing problem. They make homelessness worse,” she said. “If we can lessen the number of evictions that we’re seeing, then we can really focus on those who have been experiencing homelessness for a long time.” Breezy Poynor, the Mid-Willamette Valley Community Action Agency’s housing program director, said that she’s been getting the most questions, and seeing the most excitement, about the six months of rent subsidy for clients from the health authority.The $585,809 awarded to the agency will be used to staff the organization’s offices and help the system run smoothly.  “Being able to make sure that we have staff at each of those sites that can be educated as to what their Medicaid benefits would actually be for the clients they’re serving is really crucial,” she said.The agency will also establish a new team to educate other community organizations. “It’s pretty exciting to have this benefit out there,” Poyner said.  The added uses of Medicaid will also help engage people who may be hesitant or have trouble accessing social services, Neugebauer said.This summer, she said a man in Deschutes County was living in his RV. During the July heat wave, he had to sleep with the windows open because he didn’t have air conditioning. Because his windows were open, he lost sleep worrying about security. His mental health condition worsened from the sleep deprivation.The local homeless outreach team was able to get him an air conditioner and portable power supply using the Medicaid expansion, Neugebauer said. They saw his mental health improve.  “Some of these individuals were individuals that they had been attempting to engage in behavioral health services for years, and it was the air conditioner and the portable power supply that were the catalysts for broader engagement,” she said. “And now these individuals are receiving the behavioral health services that they have needed for quite some time.” Signs point to the Oregon Health Plan benefits helping people better engage with basic health care and other necessities, Neugebauer said.“These are very different benefits, historic from a national perspective, benefits that have never been offered before,” she said. “We are very pleased that this is the direction health care is going here.”Contact reporter Abbey McDonald: [email protected] or 503-575-1251. A MOMENT MORE, PLEASE– If you found this story useful, consider subscribing to Salem Reporter if you don’t already. 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